May 30, 2017
Washington Healthcare Update
Long-awaited CBO score for House repeal bill released…Senate Republicans
find score shows how hard their job is as they begin drafting a different
bill…Administration releases full budget and it is dead on arrival…Congress
leaves town for Memorial Day recess.
*Due to Memorial Day recess, the next newsletter will be released on
4. State Activities
5. Regulations Open for Comment
CBO Releases Score on the American Health Care Act
On May 24, the Congressional Budget Office released
its analysis of the
American Health Care Act, the legislation to repeal and replace the
Affordable Care Act.
23 million more uninsured by 2026
Net increase in uninsured: 1 million in 2017; 19 million in 2020;
23 million in 2026
Effects by insurance type
: 9 million fewer covered in 2020; 14 million fewer in 2026
: 10 million fewer covered in 2020; 6 million fewer in 2026
: no reported change in 2020; 3 million fewer in 2026
Coverage rates: 17 percent of the nonelderly population uninsured in 2020; 18 percent uninsured in 2026
Under the ACA, about 10 percent are uninsured over the 2017-2026
10-year NET effect on the deficit is $119 billion in savings
$1,111 billion reduction in direct spending
$992 billion reduction in revenues
Medicaid cuts are $834 billion over 10 years
finds that elimination of the unearned income Medicare contribution tax
costs $172 billion over 10 years
Some plans under the AHCA do not meet CBO’s standard for health
insurance coverage. CBO counts these people as uninsured.
“CBO and JCT estimate that a few million people would buy
policies that would not cover major medical risks.”
“The existence of tax credits in the nongroup market would
encourage a second market to emerge to sell policies priced to
closely match the size of the credits.”
Bill hurts the low-income near-elderly. Increase
in uninsurance “disproportionately larger among older people with
lower income—particularly people between 50 and 64 years old with
income of less than 200 percent of the federal poverty level.”
Difference from last score: more people with ESI, fewer with
nongroup because employers see nongroup plans as “less desirable
CBO expects some states will adopt MacArthur amendment waivers to
eliminate EHB and pre-ex protections.
“About half the population resides in states that would not request
waivers regarding the EHBs or community rating, CBO and JCT
“In particular, out-of-pocket spending on maternity care and mental
health and substance abuse services could increase by thousands of dollars in a given year for the
nongroup enrollees who would use those services. Moreover, the
ACA’s ban on annual and lifetime limits on covered benefits would
no longer apply to health benefits not defined as essential in a
“Some enrollees could see large increases in out-of-pocket spending
because annual or lifetime limits would be allowed
ESI possible but unlikely. “That decision could allow annual and
lifetime limits on benefits not included in the state’s EHBs.
However, large employers already have considerable flexibility in
the range of the benefits they include in their plans, so CBO and
JCT expect that their benefit offerings would probably not be
noticeably affected by the actions of states.
“The agencies estimate that about one-sixth of the population
resides in areas in which the nongroup market would start to become unstable beginning in 2020.”
“CBO and JCT expect that, as a consequence, the waivers in those
states would have another effect: Community-rated premiums would
rise over time, and
people who are less healthy (including those with preexisting
or newly acquired medical conditions) would ultimately be
unable to purchase comprehensive nongroup health insurance
at premiums comparable to those under current law, if they could
purchase it at all—
despite the additional funding that would be available under
H.R. 1628 to help reduce premiums
In some areas, the “market would be similar to the nongroup market
before the enactment of the ACA, in which premiums were
underwritten and plans often included high deductibles and limits on insurers’ payments
and people with high expected medical costs were often unable to obtain coverage.”
will depend on state action.
In states without waivers: “average premiums in the nongroup market
would be about 4 percent lower in 2026 than under current law,
mostly because a younger and healthier population
would be purchasing the insurance.”
In a state without waivers, a 64-year-old would pay $16,100 annually in premiums NET of tax credit
“About one-third of the population resides in states that would
make moderate changes to market regulations. In those states, CBO
and JCT expect that, overall, average premiums in the nongroup
market would be roughly 20 percent lower in 2026 than under current
law, primarily because, on average, insurance policies would
provide fewer benefits.”
In a state with moderate changes, a 64-year-old would pay $13,600 annually in premiums NET of tax credit
In dual waiver states:
“Average premiums would be lower than under current law because
a younger and healthier population would be purchasing the
insurance and because large changes to the EHB requirements
would cause plans to
cover a smaller percentage of expected health care costs
Less healthy people would face extremely high premiums,
despite the additional funding that would be available
under H.R. 1628 to help reduce premiums.
Over time, it would become more difficult for less healthy
people (including people with preexisting medical conditions)
in those states to purchase insurance because their premiums
would continue to increase rapidly.”
NB: CAP previously published examples of
premium surcharges for pre-existing conditions.
- STABILITY FUNDS:
- Patient and State Stability Fund “grants would exert substantial
downward pressure on premiums in the nongroup market and would help
encourage insurers’ participation in the market.”
- Invisible risk-sharing “program would have a small effect on
premiums in 2018 and a larger effect on premiums in 2019 after
insurers had time to incorporate the availability of the funds into
- Availability of money in the Upton fund for waiver states “would
increase the number of states choosing such a waiver.”
- “Although CBO and JCT expect that federal funding would have the
intended effect of lowering premiums and out-of-pocket payments to
some extent, its effect on community rated premiums would be small
because the funding would not be sufficient to substantially reduce the large increases
in premiums for high-cost enrollees
This is the third CBO score of AHCA (H.R. 1628). Before passing it,
Republicans made changes to the bill that CBO didn’t have time to analyze.
Those last-minute changes reduced savings by $32 billion over a decade,
compared to the earlier version of the bill, and resulted in one million
fewer people losing coverage. The previous scores both estimated that 24
million would lose coverage. The estimated 10-year deficit reduction fell
from $337 billion in the first score to $150 billion in the second and to
$119 billion in the May 24 score.
The estimated savings would have fallen another $68 billion had House
Republicans not delayed by six years repeal of the 0.9 percent Medicare
surtax on the wealthy (individuals with annual incomes of at least $200,000
and families with incomes of $250,000).
House Ways and Means Committee Advances Three Obamacare Repeal Bills
On May 24, the House Ways and Means Committee
three pieces of health care legislation that make up part
of the Republicans’ larger Obamacare replacement strategy. The bills were
written to work in conjunction with the GOP’s repeal bill, which is being
fast-tracked through the budget reconciliation process.
The VETERAN Act (H.R. 2372), approved with no Democratic support, allows
veterans to retain eligibility for Obamacare’s subsidies in the event that
the American Health Care Act becomes law. Republicans
billed the measure as a way to provide veterans with equal treatment and
ensure their access to care. Democrats, however, blasted the legislation,
saying it wouldn’t protect veterans with pre-existing medical conditions
under the Republican bill to repeal Obamacare, which allows states to opt
out of certain coverage protections.
The Broader Options for Americans Act (H.R. 2579) would allow tax credits
available under the American Health Care Act to be applied
to COBRA plans. The panel approved that measure with one Democrat, Ron Kind
(D-WI), voting with Republicans.
The Verify First Act (H.R. 2581), approved with no Democratic support,
would require individuals to verify their income eligibility and
citizenship or legal immigration status with the Social Security
Administration before accessing premium tax credits.
The votes came shortly after the CBO released its score of Republicans’
Obamacare repeal bill that passed the House last month. The CBO estimated
the legislation would result in 23 million more people without health
insurance by 2026, while trimming the deficit by $119 billion over 10
Congressmen Urge Congress to Keep Gun Policy Riders Out of Funding
A bipartisan group of 120 congressmen led by Rep. Mike Thompson (D-CA),
chairman of the House Gun Violence Prevention Task Force, is asking leaders
to ensure that all funding bills exclude gun policy riders.
sent a letter
to House Speaker Paul Ryan and Minority Leader Nancy Pelosi asking to keep
such riders, including the Dicky Amendment that bans the CDC from
researching gun violence, out of must-pass legislation.
“Our communities have been devastated by gun violence, and the American
people have had enough,” Thompson said in a statement. “After countless
mass shootings and acts of violence in our communities, our nation is
keeping a close eye on the actions we take to address our gun policies. Any
changes to our laws should be taken seriously. Amendments should be debated
and thoroughly vetted—not tacked on to must-pass appropriations bills.
Attaching harmful riders would be irresponsible and disrespectful to those
who lost their lives to gun violence.”
For more information,
Republicans Urge Trump to Fire NIH Director Over Embryonic, Stem Cell
Forty House Republicans are urging President Donald Trump to fire the
director of the NIH over his support for embryonic and stem cell research
that they say conflicts with Trump’s “pro-life direction.”
The Republican House members, in a
letter led by
Rep. Jim Banks (R-IN), question NIH Director Francis Collins’ support for
embryonic cloning and for stem cell research that involves the destruction
of human embryos.
“While we deeply respect Dr. Collins’ Christian faith and commitment to
public service, the stances that Dr. Collins has taken in the past
regarding embryonic stem cell research and human cloning are not
life-affirming and directly conflict with the pro-life direction of your
new presidency,” the lawmakers wrote. “It is because of this troubling
paradox that we ask you to re-consider his leadership role at NIH.”
Collins has led the NIH since 2009, when he was
by the Senate.
It has been unclear whether Trump will keep Collins, who came in at the
beginning of the Obama administration, at the helm of the biomedical
research institution. But Collins has wide support from both Republicans
The 40 Republicans argue Collins does not share in their party’s position
on embryonic research. They wrote that Collins’ stance is particularly
disturbing considering that NIH’s funding for human embryonic stem cell
research increased from $146 million in 2012 to $180 million in 2015.
Senate Democrats Express Concern Over Delaying Tobacco Rule
to FDA Commissioner Scott Gottlieb over his agency’s decision to delay
parts of an Obama-era regulation covering non-traditional tobacco products,
including the electronic cigarette industry.
Sen. Patty Murray (D-WA), who pressed Gottlieb on the issue during his
confirmation hearing, wrote with 10 colleagues that delaying compliance
deadlines 92 days puts children’s health at risk.
“Every day that these products stay on the market with no assessment of
their risks, we continue to put America’s youth in harm’s way,” the
lawmakers wrote. In addition to Murray, others signing the letter included
Sens. Jeff Merkley, Sherrod Brown, Tom Udall, Ed Markey, Sheldon
Whitehouse, Jack Reed, Elizabeth Warren, Dick Durbin, Richard Blumenthal
and Al Franken.
The FDA proposed and finalized a rule under which it would apply the
Tobacco Control Act to bring products like e-cigarettes, cigars, hookah and
pipe tobacco under the agency’s purview. Public health advocates and many
Democrats have pushed for curbs on candy and fruit flavors they say
e-cigarette companies use to target children, but did not get them in the
final rule. The e-cigarette industry argued that the regulation would kill
off small producers.
Administration Unveils Budget Detail
The Trump administration unveiled its budget on May 23, cutting deeply into
programs for the poor, health care, science and other areas, while boosting
defense 10 percent and spending more than $2.6 billion for border security
as well has significant tax reductions. The budget document titled “A New
Foundation for American Greatness” frames its plan as “reform the welfare
system and replace dependence with dignity of work.”
The budget is seen as “dead on arrival” by Congress, but it serves as an
outline for the administration’s priorities.
The proposal makes no changes to Medicare, an entitlement program that
drives a significant percentage of the nation’s debt. However, it does
reduce Medicaid spending.
The Trump administration would cap Medicaid’s federal funding for the first
time, saving $610 billion over 10 years. States would receive fixed funding
with new flexibility to administer their programs.
The budget also envisions saving funds—$250 billion—from Medicaid through
the repeal of the Affordable Care Act.
In health care the budget does the following:
FDA: The budget slightly increases the agency’s overall funding levels
by $456 million. However it reduces taxpayer funding by about $854
million from 2017 levels. Industry user fees would be increased by more
than the $1 billion drug and device manufacturers had already
negotiated with Congress. It also includes $60 billion in funding
previously authorized by the 21st Century Cures Act.
Mental Health and Substance Abuse
- The Substance Abuse Mental Health Services Administration would be
reduced by $400 million
- Community Mental Health Services Block Grant would be reduced by $116
- State Mental Health Grants would be reduced by $136 million
- Substance Abuse Treatment Grants for states would be reduced by $73
- Public awareness programs would be reduced by $74 million
National Institutes of Health funding would be reduced by almost $6
- NIH funding is similar to the proposal the administration sent early this
year, and comes weeks after Congress gave the agency a $2 billion boost in
its 2017 spending bill.
- The budget folds into NIH the Agency for Healthcare Research and Quality
while maintaining the $272 million in discretionary funding for the
agency’s work. It also restructures the way in which AHRQ processes grants
to reduce overhead costs.
Center for Disease Control and Prevention
- The budget includes a $500 million health block grant for states to
respond to public health threats.
ONC budget is proposed to be reduced to $38 million.
Office for Civil Rights would be reduced to $33 million though the
office can generate more money for itself through aggressive HIPAA
The budget also envisions a 3 percent growth rate in the economy. Many
economists believe that percentage of growth is not achievable and that 1.9
percent is a more realistic figure.
FDA Hiring Freeze Lifted
The FDA is no longer subject to the hiring freeze the Trump administration
imposed in late January, Commissioner Scott Gottlieb wrote in an email to
“Senior leadership has worked very closely with the administration over the
last several months, and just as I do, they see the critical importance of
the FDA’s staff in achieving our mission,” Gottlieb wrote.
He added more details will be forthcoming about a new streamlined and
efficient process for filling job openings. The FDA currently has about
The hiring freeze frustrated Republicans and Democrats who passed the 21st
Century Cures legislation late last year with provisions to make it easier
for FDA to recruit and retain staff to help the agency speed more drugs and
devices to market.
OMB lifted the government-wide ban on hiring in mid-April, however HHS
elected to continue the freeze. FDA was given the ability to hire for some
positions funded by industry user fee dollars.
Gottlieb Launches Panel to Study Opioid Crisis
FDA Commissioner Scott Gottlieb has
established a steering committee to address the opioid crisis and advise regulators on
such steps as prescription limits.
Gottlieb, who said during his confirmation hearing that overuse of
painkillers was his top priority, wrote in a blog post that the committee
will address whether the FDA should mandate training for health
professionals and work with providers to ensure the number of doses
prescribed is closely related to the condition for which a patient is being
Gottlieb mentioned how there are few situations when a patient needs a
30-day supply of opioids. The committee will also consider whether the
agency’s drug review process for opioids adequately considers risk and the
potential for abuse.
The actions are the first Gottlieb has taken on opioid misuse since taking
the helm of the FDA. The steering committee will be made up of senior
agency leaders and will solicit public comment. Gottlieb said the agency
will also consider additional steps.
NIH to Launch Beta Test of Precision Medicine Initiative This Week
A beta test of the Precision Medicine Initiative will launch this week, its
project leader said at an NIH panel meeting May 25.
PMI, in the initial rollout, will recruit the first 10,000 to 15,000
participants toward the eventual goal of 1 million. The beta effort will be
spearheaded by the University of Pittsburgh Medical Center and will feature
“real people, real protocol, and real training,” said project leader Eric
Dishman. Only basic samples (like blood and urine) and measurements (like
waist circumference and BMI) will be collected at first.
A national rollout is planned for next year. Some parts of the
infrastructure are not ready yet. While the biobank at Mayo Clinic is close
to accommodating a beta test, it can’t yet deal with a test of national
scale. Meanwhile, the researcher portal—which allows academics to make
inquiries of the data—isn’t ready yet either.
HHS Secretary Price Calls for Reforming World Health Organization
On May 22, while addressing the World Health Assembly, HHS Secretary Tom
Price said the World Health Organization should be reformed to focus on
preventing global health crises.
A reform effort means “taking a clear-eyed view of what needs to change for
it to fulfill that most important mission: ensuring a rapid and focused
response to potential global health crises,” he said.
WHO will elect a new director-general on Tuesday, replacing Margaret Chan,
who has held the position since 2006.
Judge Orders HHS, OMB to Release Communications With Congress to
On May 25, a federal judge ordered the Trump administration to review more
than 13,000 pages of internal records related to Republicans’ health care
legislation and to release relevant materials to American Oversight, a
501(c)(3) organization launched to scrutinize the Trump administration
through Freedom of Information Act requests.
In March, American Oversight sent FOIA requests to both HHS and OMB,
seeking the agencies’ internal communications with Congress about
Republicans’ health care legislation. Because FOIA requests can take years
to fulfill, American Oversight asked for expedited processing, which would
have forced HHS and OMB to turn over the documents within weeks or months.
But according to American Oversight’s
complaint, the administration did not agree to expedite processing, which opened the
case up for judicial review.
Judge Emmet G. Sullivan of the U.S. District Court of the District of
Columbia agreed, and ordered HHS and OMB to review and
process about one-third of their communications by June 30, another
one-third by July 31 and the remaining documents by Sept. 5. The agencies
also were ordered to turn over nonexempt materials to American Oversight on
a rolling basis on those dates.
CMS Staffers Charged With Insider Trading of Political Intelligence
On May 24, federal authorities filed charges against current and former CMS
employees for allegedly committing insider trading involving so-called
From May 2012 through November 2013, Christopher Worrall, a senior staffer
at the CMS office that sets Medicare reimbursement rates, gave nonpublic
and potentially profitable information to his close friend and former
colleague David Blaszczak, according to civil charges announced by
the SEC. The U.S. Attorney’s office for the Southern District of New York
announced related criminal charges.
Blaszczak, in turn, gave the information on the government’s plans to cut
reimbursement rates to two clients, who were also charged, the SEC said.
Those two individuals, Theodore Huber and Jordan Fogel, placed trades on
behalf of certain hedge funds, yielding more than $3.9 million in illegal
State AGs Reach Settlement in Generic Drug Price-Fixing Investigation
Two former pharmaceutical executives involved in a price-fixing scheme have
agreed to cooperate with a broader investigation into allegations of
widespread anticompetitive activity in the generic drug industry as part of
reached with 41 states.
Former Heritage Pharma CEO Jeffrey Glazer and Jason Malek, the company’s
former president, have agreed to provide information, documents, testimony,
depositions and other evidence to support the states’ investigation. They
will also each pay a $25,000 civil penalty to the states.
Glazer and Malek pleaded guilty to fixing prices of a popular antibiotic
and a diabetes medication in January, as part of a federal investigation
into alleged conspiracy among leading giants in the generic drug market.
The states say this scheme led to higher prices for consumers and state
governments. The attorneys general have also filed suit against Aurobindo
Pharma USA, Citron Pharma, Mayne Pharma, Mylan Pharmaceuticals and Teva
Pharmaceuticals for their roles in the alleged conspiracy to artificially
inflate and manipulate prices and reduce competition for these two drugs.
The federal investigation into price fixing is believed to include about
two dozen drug companies.
Another 90-Day Delay for ACA Insurance Subsidies Suit
The Trump administration and House of Representatives today asked a federal
court for another 90-day delay in a lawsuit over Obamacare insurance
subsidies, undermining the future of the health care marketplaces as
insurers look for certainty from the government before committing to offer
coverage next year. If the request is approved, the parties would have to
file another update in 90 days.
“The parties continue to discuss measures that would obviate the need for
judicial determination of this appeal, including potential legislative
action,” the House and White House
wrote to the court (aca subsidies
The suit, House v. Price, centers on Obamacare’s cost-sharing
program, which reimburses health insurers to help low-income people make
copayments at the doctor or hospital. The case was brought by House
Republicans during the Obama administration. But the case has taken on
added significance as Republicans try to repeal the health law: without the
$7 billion in payments, insurers say they cannot remain afloat in the
President Donald Trump has argued that the markets are fatally flawed and
will collapse no matter what his administration does. He also suggested
that the ensuing chaos could entice Democrats to come to the bargaining
table and help craft a health care overhaul.
The administration declined to say if it will make more cost-sharing
The subsidies have already been paid for May. If the request is approved,
the parties would have to file another update in 90 days.
4. State Activities
California: Committees Approve 2017-18 Budgets
The California Assembly and Senate budget committees recently approved
their own versions of the 2017-18 state budget, which uses a portion of
tobacco tax funds to provide state Medicaid coverage to young adults up to
age 26, regardless of immigration status. Those funds would also go toward
increasing provider rates and restoring some previously cut services. This
approach by the legislative committees stands in contrast to Gov. Jerry
Brown’s proposed budget, which recommends using the new tax funds—expected
to raise more than $1 billion for Medi-Cal improvements—to fund general
Medi-Cal costs and help backfill some of the program’s shortfalls. Each
house also agreed to use $50 million to increase rates specifically for
Planned Parenthood and other family-planning providers who participate in a
state program for low-income residents.
Indiana: Gov. Holcomb Starting Work Requirements on Medicaid
Indiana Gov. Eric Holcomb is getting a jump-start on the Republicans’ call
to implement work requirements on Medicaid beneficiaries. The Republican
governor said he is asking CMS officials for permission to require some
Medicaid recipients to work or do work-related activities. CMS
Administrator Seema Verma was a health care consultant in Indiana who
helped create the Healthy Indiana Plan, the state’s conservative Medicaid
expansion plan, which Indiana is seeking to extend for another three years.
The state estimates the work requirement would affect about 30 percent of
current recipients, and only those who are able bodied and younger than 60.
5. Regulations Open for Comment
FDA Considers Establishing New Office of Patient Affairs
The FDA is considering establishing a new Office of Patient Affairs that
would centralize its work on patient involvement in the review and approval
of drugs and medical devices, according to a
March 14 notice
in the Federal Register.
Comments on the new office are due by June 12, 2017.
CMS Releases Proposed Hospital Pay Rule
In a new proposed
2018 Medicare payment rule, CMS
says it will look to cut hospital industry regulations and streamline
oversight, and it’s asking hospitals themselves for help. The agency is
soliciting ideas for changes to rules and procedures governing acute-care
and long-term care hospitals. The initiative aims to “relieve regulatory
burdens for providers,” as well as promote flexibility and innovation, CMS
said in a statement.
The new proposed rule would suspend for one year a provision penalizing
long-term care hospitals that receive more than 25 percent of patients from
a single acute-care hospital. It would also reduce certain quality
reporting requirements for hospitals that have implemented electronic
CMS projects the rule would increase Medicare spending on inpatient
hospital services by $3.1 billion in 2018, with operating payments to
hospitals increasing 2.9 percent. Long-term care hospitals’ Medicare
payments are projected to decrease by $173 million, or 3.75 percent, over
the same period.
Comments on the rule must be submitted no later than 5 p.m. EDT on June 13,
CMS Proposes 2018 Payment and Policy Updates for Medicare Hospital
CMS is offering hospitals a 90-day meaningful use reporting period in 2018,
according to a
proposed payment rule
released April 14.
The first major payment regulation released under HHS Secretary Tom Price
marks a change from the back-and-forth over electronic health records
meaningful use requirements seen under the Obama White House. The previous
administration would typically propose a yearlong reporting period, then
scale it back at the last minute after intense lobbying pressure. As a
Republican congressman from Georgia, Price often pushed the Obama
administration hard for 90-day meaningful use reporting periods.
In connection with the 21st Century Cures Act, CMS also is
to remove from meaningful use clinicians who see most of their patients at
ambulatory surgery centers.
Price and CMS are also changing previously finalized requirements from
electronic clinical quality measures. Under the proposed rule, hospitals
can select six measures and report on them for the first three quarters of
For more information,
CMS is Accepting Measure Submissions for the Advancing Care Information
Performance Category until June 30
CMS is still accepting measures for the Advancing Care Information
performance category of the Merit-based Incentive Payment System (MIPS).
The Annual Call for Measures and Activities ends June 30, 2017.
CMS encourages providers to identify and submit measures for the MIPS
Advancing Care Information performance category. To be considered,
proposals must include specific criteria including, but not limited to,
measure description, measure type and numerator and denominator
CMS requests that stakeholders consider outcome-based measures, patient
safety measures and cross-cutting measures that use certified EHR
technology to support the improvement activities and quality performance
categories of MIPS.
Advancing Care Information Submission Form
to propose measures for inclusion, and send the form to
To learn more about the process for submitting measures, please visit the
Call for Measures
webpage, and review the
Call for Measures and Activities fact sheet.
CMS Looks to Boost Medicare Payments to Rehab Hospitals, Nursing
Facilities and Hospices
CMS could boost Medicare payments to a swath of rehabilitation hospitals,
nursing facilities and hospices under a trio of new proposed rules.
On April 27, the agency floated a
$390 million bump
in federal payments to skilled nursing facilities in 2018—or roughly 1
percent higher than this year. Hospices, meanwhile,
a 1 percent increase worth $180 million.
to increase reimbursement to rehab hospitals by $80 million for 2018, in
addition to eliminating a penalty on facilities that don’t submit certain
data to the federal government on time.
proposed payment rules for other
providers, CMS is asking the industries for input on regulations it should
overhaul or eliminate. CMS Administrator Seema Verma and HHS Secretary Tom
Price have pledged to review all of the agency’s rules in a bid to cut
unnecessary or burdensome regulations.
Comments on the trio of rules must be received no later than 5 p.m. on June
CMS Seeking Comments on Data Elements in IMPACT Act
CMS has contracted with the RAND Corporation to develop standardized
patient/resident assessment data elements in alignment with the Improving
Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).
CMS seeks comments from stakeholders on data elements that meet the IMPACT
Act domains of cognitive function and mental status; medical conditions and
co-morbidities; impairments; medication reconciliation; and care
preferences. The public comment period opens on April 26, 2017, and closes
on June 26, 2017.
For more information, view the
CMS Issues 2018 IPPS Proposed Rule
CMS issued the FY 2018 Inpatient Prospective Payment System (IPPS) and Long
Term Acute Care Hospital (LTCH) rule on April 14, which proposes a number
of changes to the Medicare and Medicaid Electronic Health Record (EHR)
The proposals include:
For CY 2018, modifying the EHR reporting period from the full calendar
year to a minimum of any continuous 90-day period for new and returning
participants in the Medicare and Medicaid EHR Incentive programs.
Adding a new exception from the Medicare payment adjustments for
Eligible Professionals (EPs), Eligible Hospitals and Critical Access
Hospitals (CAHs) that demonstrate through an application process that
complying with the requirement for being a meaningful EHR user is not
possible because their certified EHR technology has been decertified
under ONC’s Health IT Certification Program.
Implementing a policy in which no payment adjustments will be made for
EPs who furnish “substantially all” of their covered professional
services in an ambulatory surgical center (ASC); applicable for the
2017 and 2018 Medicare payment adjustments.
Using Place of Service (POS) code 24 to identify services furnished in
an ASC as well as requesting public comment on whether other POS codes
or mechanisms should be used to identify sites of service in addition
to or in lieu of POS code 24.
Comments must be submitted by 5 p.m. on June 13, 2017.
To learn more, review the
CMS Publishes Post-Acute Care Proposed Rules
On May 11, CMS published the following proposed rules:
GAO Testimony Finds Weaknesses in Programs Serving Indian Tribes
new testimony, GAO finds that actions are needed to address serious weaknesses in
federal management of programs serving Indian tribes.
The Department of the Interior and the Department of Health and Human
Services offer education, energy resource management, health care and other
programs for Indian tribes and their members.
GAO testified on both departments’ weaknesses in managing these programs.
These weaknesses have contributed to unsafe conditions at Bureau of Indian
Education schools, limited or missed opportunities for tribes to use energy
resources for their economic benefit, and inadequate oversight of federal
health care facilities that serve tribes.
2017 High Risk report
highlighted nearly 40 recommendations that could help address these issues.
GAO Releases Report on Electronic Cigarette Imports
In a new report, GAO analyzed data on U.S. imports of electronic cigarettes
and found that the value of U.S. e-cigarette imports totaled about $342
million in 2016—and brought in about $9 million in tariff revenue.
E-cigarette devices accounted for nearly 60 percent of the value of these
imports, parts for nearly 32 percent and liquid for almost 9 percent. And,
although e-cigarettes were imported from 41 countries, China accounted for
91 percent of imports by value.
To see the report,
GAO Releases Report on Responding to Zika Virus Disease Outbreaks
In a new report, GAO examines (1) information on what is known and not
known about the epidemiology of the Zika virus, and any challenges with
conducting surveillance and epidemiological studies; (2) characteristics of
different diagnostic tests authorized during the outbreak, challenges test
manufacturers and users faced, and the extent to which FDA and CDC followed
their own communication guidance; and (3) the strengths and limitations of
available mosquito control methods and challenges federal agencies face
supporting these efforts.
GAO made five recommendations to FDA and CDC based on its findings,
including that CDC establish a transparent process for providing test
manufacturers access to diagnostic tests and that both agencies provide
information to help ensure that users of diagnostic tests can compare
To see the report,
To read GAO’s testimony on the report,
If you have any questions, contact the following individuals at
Kennan, Senior Vice President
Charlie Iovino, Vice
Caroline Perrin, Research Assistant
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